Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with Multiple Drugs (Leflunomide and Cefuroxime): A Case Report

What is it about?

Sometimes, people can have unexpected and serious reactions to medications, even when the drugs are taken correctly. One such reaction is called DRESS syndrome (drug rash with eosinophilia and systemic symptoms). It’s a rare but dangerous condition that can affect many organs, like the liver, kidneys, and lungs, and includes symptoms like skin rashes, fever, and swelling. Recognizing and treating it quickly is important to help the person recover and avoid serious complications. In this case, a 42-year-old woman developed symptoms of DRESS syndrome after taking leflunomide, a medication used for foot pain (plantar fasciitis). Her symptoms included fever, stomach issues, facial swelling, skin rash, liver problems, and enlarged organs. Tests confirmed a strong link between the drug and the reaction. She improved after stopping the medication and receiving appropriate care. However, after recovering, she experienced similar symptoms again after taking another medicine, cefuroxime, an antibiotic. This also appeared to cause a DRESS-like reaction. Both drugs were assessed as likely causes of her symptoms.

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Photo by Towfiqu barbhuiya on Unsplash

Photo by Towfiqu barbhuiya on Unsplash

Why is it important?

This case highlights that both leflunomide and cefuroxime can potentially trigger DRESS syndrome. Doctors and patients should be cautious with these medications, and any such reactions should be reported to health authorities to help prevent future cases.